Archived: Brookhouse Medical Centre

Updated 24 August 2017

Brookhouse Medical Centre is situated close to the centre of Blackburn at Whalley Range, BB1 6EA. It delivers primary medical services to a patient population of approximately 6200 patients via a general medical services (GMS) contract with NHS England. The practice is part of the NHS Blackburn with Darwen Clinical Commissioning Group (CCG). The premises has a car park with disabled spaces nominated, as well as a ramp to facilitate access to the building for those patients experiencing mobility difficulties.

The average life expectancy of the practice population is slightly below the national averages (77 years for males and 81 years for females, compared to 79 and 83 years respectively nationally).

The practice has a higher proportion of younger patients than the average practice both locally and nationally. For example, 20% of the practice population are aged between five and 14 years, compared to the local average of 14% and national average of 12%. The proportion of patients under the age of 18 years at the practice is 33%, compared to the local average of 25% and national average of 21%. Conversely, the practice caters for a lower proportion of older patients; for example just 5% are aged over 65 compared to the local average of 14% and national average of 17%.

Information published by Public Health England estimates that 70% of the practice’s patient cohort is of Asian ethnic background.

Information also published by Public Health England rates the level of deprivation within the practice population group as two on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice is staffed by the GP provider (male) along with three long term locum GPs (one female and two males). In addition the practice employs two advanced nurse practitioners, two practice nurses and a health care assistant. Clinical staff are supported by a practice manager and a team of nine administrative and reception staff.

The practice is a teaching and training practice, taking medical students as well as registrars.

The practice is open between 8am and 6.30pm each weekday apart from Monday, when extended hours appointments are offered until 7.30 in the evening. Surgeries are offered throughout the practice’s opening times.

Outside normal surgery hours, patients are advised to contact the out of hour’s service by dialling 111, offered locally by the provider East Lancashire Medical Services.

Updated 24 August 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Brookhouse Medical Centre on 5 July 2017. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events. We saw that learning from significant events was communicated with staff effectively and staff were aware of any changes implemented as a result in order to minimise the risk of the event being repeated.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients had rated the practice lower than others for many aspects of care. However, the survey period related to a period of transition for the practice, with a new provider taking over. Patient feedback we received as part of the inspection process indicated patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• While some patients expressed concerns regarding appointment access, we saw that the practice was taking action to address these concerns and there was improved continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt very supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Work to validate the carers list should be completed and alerts on the electronic records used to facilitate and maximise access to appropriate support services.

• Since funding has been secured, the planned work to replace carpets in clinical rooms should be completed at the earliest opportunity.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 24 August 2017

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in long-term disease management and patients at risk of hospital admission were identified as a priority.

• Performance against the Quality and Outcomes Framework for long term conditions was either in line with or higher than local and national averages.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.

• All these patients had a named GP and there was a system to recall patients for a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 24 August 2017

The practice is rated as good for the care of families, children and young people.

• We saw there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency (A&E) attendances.

• Immunisation rates were relatively high for all standard childhood immunisations.

• The practice had implemented actions to improve the uptake of cervical screening.

• Patients told us, on the day of inspection, that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice worked with midwives, health visitors and school nurses to support this population group. For example, in the provision of ante-natal, post-natal and child health surveillance clinics.

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 24 August 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life. It involved older patients in planning and making decisions about their care, including their end of life care.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

• Where older patients had complex needs, the practice shared summary care records with local care services.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

Updated 24 August 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of these populations had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care, for example, extended opening hours appointments.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 24 August 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice carried out advance care planning for patients living with dementia.

• The percentage of patients diagnosed with dementia whose care had been reviewed in a face to face review in the preceding 12 months was 100% compared to the CCG average of 87% and national average of 84%.

• The practice specifically considered the physical health needs of patients with poor mental health and dementia.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• The practice had a system to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 24 August 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.